Dapagliflozin: where does it fit in the treatment of type 2 diabetes?

Diabetes incidence continues to increase dramatically and is associated with serious microvascular and macrovascular complications. People with type 2 diabetes form a heterogeneous group; treatment regimens and therapeutic targets must take these individual circumstances into account. The number of available antihyperglycemic agents is expanding, requiring the clinician to consider many of the following factors when choosing medications: degree of hyperglycemia, risk of hypoglycemia, medication side effects, concomitant medical conditions, ability to adhere to regimen, and patient preferences. Lifestyle modification, including nutritional therapy and physical activity, should continue to be emphasized while pharmacotherapy is being used. Newer medications with unique mechanisms of action are still needed, as many patients fail to reach glycemic targets. Dapagliflozin is a sodium-glucose co-transporter 2 inhibitor that reduces hyperglycemia by inducing significant amounts of glucosuria. Clinical trials are defining the characteristics of this new class of medication and initial results are promising.